Clinical Significance of Postradiotherapy [18F]-Fluorodeoxyglucose Positron Emission Tomography Imaging in Management of Head-and-Neck Cancer—A Long-Term Outcome Report

Yao, Min; Smith, Russell B.; Hoffman, Henry T.; Funk, Gerry F.; Lu, Minggen; Menda, Yusuf; Graham, Michael M.; Buatti, John M.

doi:10.1016/j.ijrobp.2008.07.019

Cited by 104 publications

(60 citation statements)

References 22 publications

(25 reference statements)

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“…It is recognised that a negative PET/CT after CRT may allow omission of the neck dissection, avoiding unnecessary surgery and all the associated risks and potential morbidity [7][8][9][10][11][12][13]. The data from this study are consistent with prior studies in confirming this finding.…”

Section: Discussionsupporting

confidence: 89%

The role of positron emission tomography/CT imaging in head and neck cancer patients after radical chemoradiotherapy

Sherriff

Ogunremi²,

Colley³

et al. 2012

The British Journal of Radiology

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Objectives: Positron emission tomography with CT (PET/CT) scanning is increasingly being used in head and neck cancer to assess response after radical concomitant chemoradiotherapy. The purpose of this study was to assess the use of PET/CT following chemoradiotherapy at our institution. Methods: All patients receiving radical chemoradiotherapy for head and neck cancer over a 9-year period were retrospectively identified. Outcome data including local control and overall survival were collected for all patients. The negative predictive value of PET/CT for local recurrence was calculated. Of those with a reported positive PET/CT scan the maximum standardised uptake values were compared with the incidence of local recurrence. Results: 92 patients were identified having a post-treatment PET/CT from a total of 301 patients receiving radical concomitant chemoradiotherapy. Median time from completion of chemoradiotherapy to PET/CT scan was 3 (range 2-8) months. Median follow-up in surviving patients was 19 and 25 months in the PET/CT and non-PET/CT groups, respectively. The negative predictive value for local recurrence was 91.8%. The median maximum standardised uptake values were 10.2 (range 3.1-33) and 6.89 (range 3.1-30) in those with local recurrence and with no local recurrence, respectively. Conclusions: Post-chemoradiotherapy PET/CT may aid subsequent management decisions. Patients with a negative PET/CT scan after radical chemoradiotherapy have a 91.8% chance of remaining free of local recurrence 19 months post-treatment. A higher maximum standardised uptake value on the post-chemoradiotherapy PET/CT may predict subsequent local recurrence and warrants further investigation. Advances in knowledge: Post-chemoradiotherapy PET/CT imaging aids subsequent management decisions.

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Section: Discussionsupporting

confidence: 89%

The role of positron emission tomography/CT imaging in head and neck cancer patients after radical chemoradiotherapy

Sherriff

Ogunremi²,

Colley³

et al. 2012

The British Journal of Radiology

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“…Negative studies were associated with superior 2-y locoregional control (97% vs. 49%, P , 0.001), distant control (95% vs. 46%, P , 0.001), progression-free survival (93% vs. 30%, P , 0.001), and OS (100% vs. 32%, P , 0.001) when compared with positive scans. Yao et al (26) conducted a retrospective analysis of 188 patients and reported superior survival rates among patients who underwent negative PET scans within 1 y of treatment (range, 5.14-43.7 wk). The 3-y disease-free survival rate was 42.5% and 70.5% in patients with positive and negative scans, respectively (P , 0.0001).…”

Section: Discussionmentioning

confidence: 99%

Addition of ¹⁸F-FDG PET/CT to Clinical Assessment Predicts Overall Survival in HNSCC: A Retrospective Analysis with Follow-up for 12 Years

et al. 2013

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18 F-FDG PET/CT is used in the follow-up of patients with head and neck squamous cell cancer (HNSCC). However, its impact on clinical decision making and patient outcome is not fully established. The objective of this study was to determine the prognostic value of 18 F-FDG PET/CT for overall survival (OS) of HNSCC patients when performed in addition to clinical assessment between 4 and 24 mo after treatment. Methods: This was a retrospective study at a single tertiary center. The institutional review board approved this study, and the requirement to obtain informed consent was waived. The study included 134 biopsy-proven HNSCC patients with 227 followup PET/CT scans. The primary outcome measure was OS. Median follow-up was 40 mo (range, 7-145 mo). Survival is presented as Kaplan-Meier plots with Mantel-Cox log-rank test. The multivariate Cox model included clinical covariates. Results: Of the 227 PET/CT scans, 41 (18%) were positive for tumor and 186 (82%) were negative for tumor. PET/CT identified recurrence in 5% (9/194) of scans performed without prior clinical concern and ruled out tumor in 51.5% (17/33) of scans performed to evaluate clinical suspicion or uncertainty of recurrence. The median survival of PET-positive and -negative groups from the date of the scan was 20 and 30.5 mo, respectively (P , 0.0001). There was a significant difference in OS from the scan date between patients who had a positive PET/CT result for tumor and those who had a negative result (log-rank, P , 0.0001), with a hazard ratio of 29.74. Human papillomavirus status (P 5 0.001) and PET/CT result (P 5 0.04) were the only factors significantly associated with OS, adjusted for all other covariates. Conclusion: 18 F-FDG PET/CT performed between 4 and 24 mo after treatment adds value to clinical assessment at the time of the study, especially when there is clinical suspicion or uncertainty, and can serve as a prognostic marker of OS in HNSCC.

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“…Changes in glucose metabolism are often evident before the appearance of a physical change or symptom, which is crucial for the adjustment of the therapeutic regimen. 18 F-FDG PET/CT displays a high sensitivity and a relatively high specificity in the evaluation of recurrent NPC and the response to treatment (9,10).…”

Section: Discussionmentioning

confidence: 99%

Clinical value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in evaluating relapsed and refractory nasopharyngeal carcinoma: A case report

Zhao

Fang

et al. 2015

Molecular and Clinical Oncology

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Abstract. For patients with locoregionally advanced nasopharyngeal carcinoma (NPC), radiotherapy, chemotherapy and even targeted therapy are widely accepted treatments. These treatments, although they mostly achieve locoregional tumor control, they may also be associated with complex post-treatment changes, such as edema, loss of tissue planes, fibrosis, mucositis and scarring, which may interfere with the detection of local recurrence and the response to therapy. However, timely detection is crucial for deciding whether treatment modification or discontinuation is required. This is the case report of a 51-year-old nasopharyngeal carcinoma patient with cervical nodal metastases (CNM). Following radiotherapy, chemotherapy and targeted therapy, multislice spiral enhanced computed tomography (CT), enhanced magnetic resonance imaging (MRI) and 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET)̸CT of the neck were performed to compare the extent of the CNM. The enhanced CT and MRI images were unremarkable, whereas the 18 F-FDG PET̸CT images revealed the exact recurrence or remission. Therefore, 18 F-FDG PET/CT exhibits a better sensitivity and specificity for evaluating the response to combined treatment compared to CT and/or MRI.

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Clinical Significance of Postradiotherapy [18F]-Fluorodeoxyglucose Positron Emission Tomography Imaging in Management of Head-and-Neck Cancer—A Long-Term Outcome Report

Cited by 104 publications

References 22 publications

The role of positron emission tomography/CT imaging in head and neck cancer patients after radical chemoradiotherapy

The role of positron emission tomography/CT imaging in head and neck cancer patients after radical chemoradiotherapy

Addition of ¹⁸F-FDG PET/CT to Clinical Assessment Predicts Overall Survival in HNSCC: A Retrospective Analysis with Follow-up for 12 Years

Clinical value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in evaluating relapsed and refractory nasopharyngeal carcinoma: A case report

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Clinical Significance of Postradiotherapy [18F]-Fluorodeoxyglucose Positron Emission Tomography Imaging in Management of Head-and-Neck Cancer—A Long-Term Outcome Report

Cited by 104 publications

References 22 publications

The role of positron emission tomography/CT imaging in head and neck cancer patients after radical chemoradiotherapy

The role of positron emission tomography/CT imaging in head and neck cancer patients after radical chemoradiotherapy

Addition of 18F-FDG PET/CT to Clinical Assessment Predicts Overall Survival in HNSCC: A Retrospective Analysis with Follow-up for 12 Years

Clinical value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in evaluating relapsed and refractory nasopharyngeal carcinoma: A case report

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Addition of ¹⁸F-FDG PET/CT to Clinical Assessment Predicts Overall Survival in HNSCC: A Retrospective Analysis with Follow-up for 12 Years